ESMO 2025 | Recent updates in second-line therapies for biliary tract cancer

So biliary tract cancer is a sort of a poster child, I think, for precision medicine and oncology. Over the last 10 years, we’ve seen an explosion in potential treatments. From a second-line perspective, there are a variety of targeted therapies that are presently being used. Interestingly, at this same meeting, telisotuzumab vedotin was evaluated in metastasized biliary tract cancers. And indeed, a small percentage of patients with biliary tract cancers have metastasis. And in that study, of eight patients, four had partial response. So a 50% response rate that was quite durable. So another example, I think, of precision medicine in the second line. Of course, here at the meeting, we also heard about continuing efforts to target FGFR2 fusions. As you know, we have pemigatinib and futibatinib as established standards of care. However, resistance develops. So at this meeting, we saw the utilization of tenatinib, a tyrosine kinase inhibitor that blocks FGFR and other key proteins and has been shown, at least in preclinical models, to work in the resistance state. And so, these were important data. Of course, generally, I think there is a push to evaluate antibody drug conjugates in the second line. Telisotuzumab vedotin is one such approach, but there are others. We saw ongoing studies that are looking at TROP2-directed ADCs and others, and we’ll weigh those data.

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